Monday May 5 2014

Why is my head balding at a young age?

Dear Doctor: I am 21 years old and already developing a bald head. Recently, I went out with my friends and someone greeted me as mzee yet I am young. Please help me before I commit suicide.


Dear James: Though hair on our heads protects us from the sun’s dangerous ultra violet rays, it is largely of cosmetic value which is why balding, especially when it comes at a young age like in your case, can lead to a lot of stress. That said, the bald head is no reason to commit suicide when you are young with a great future ahead of you.

Balding, which is mostly genetic, happens when instead of manufacturing thick hair, our bodies produce small hairs which are too tiny to see with our naked eyes. A male hormone (dihydro-testesterone) and a substance prostaglandin D2 are said to be associated with balding in such people.

It is true balding is more common in older people, the reason you were called mzee but in some people with male-pattern baldness, it can begin as early as puberty and may affect women after menopause. That said, there are other causes of balding some of which may be temporary provided the cause is identified and rectified.

This is why you should visit a doctor to rule out these conditions which include thyroid problems, alopecia areata, where by the body’s immune system attacks hair, scalp infections such as ring worm, drugs for cancer and stress.
Depending on the cause, sometimes balding may correct itself spontaneously or after the cause has been addressed. However, there are medicines which may help slow or prevent the development of common baldness but are only prescribed by a doctor after diagnosis. It may take up to six months before you can tell if the medicines are working, which creates more stress requiring that apart from drugs, you should be counselled.

Dear Doctor: When I eat and get satisfied, I feel dizzy. Recently after eating my favourite food, which is kalo and meat, and stood up to get water, I got dizzy and fell. I think I temporarily did not comprehend anything. Can eating kalo cause epilepsy? Please advise because I love my kalo.

Dear Stephanie: It is most likely that you fainted. Fainting is the temporary loss of consciousness followed by its immediate recovery. This may be accompanied by loss of muscle tone, resulting in falling. When this is accompanied by passing urine, soiling oneself and foaming at the mouth, then epilepsy is usually suspected but cannot be diagnosed from only one fall.
Upon standing after a meal, fainting usually results from a drop in blood pressure (post-prandial hypotension) because most of it has gone and pooled in the abdominal organs to aid food digestion and absorption. Because of this pooling, the amount of blood available to the general circulation drops, causing blood pressure to fall, especially when standing upright. With the pooling, the body usually compensates by the heart beating faster and the blood vessels far away from the areas of digestion, especially in the legs, narrowing (reflex vasoconstriction).

As people grow older, or in cases where they have hypertension, the blood vessels harden making adjustment of narrowing difficult. Also, after a stroke, people on some hypertension drugs, those who are anaemic or have nerve diseases may be at a high risk because of failing to adjust to a drop in pressure after eating.

People who have postprandial hypotension may show other symptoms like, lightheadedness, dizziness, weakness especially when they stand up within 30 to 60 minutes after a meal. Symptoms tend to be more severe after eating a meal that includes a lot of carbohydrates, or if they have taken alcohol.
Any person with postprandial hypotension needs to change their lifestyle to lessen the likelihood of its occurrence.

Drinking a glass of water before a meal, eating smaller, more frequent than large carbohydrate meals (kalo is a carbohydrate meal), avoiding alcohol before a meal because it relaxes blood vessels and interferes with constriction of leg blood vessels, staying seated for 30 to 60 minutes after eating may be helpful. If they do not, please see your doctor.

You can eat your kalo but in small amounts at a time. Kalo does not cause epilepsy though in Uganda today, one should be careful about kalo flour in many markets because some may be from the types of cassava with high levels of cyanide.

Dear Doctor: I have two sons. One is in Primary Three and the other is in Baby Class. The older boy used to suffer a lot from cough and flu but is now better, and the younger one gets sick from the same every week. Is cough and flu a family problem?
Denis Kajja

Dear Denis: A runny or stuffy nose is locally referred to as flu, though this can result from a common cold virus of which there are more than 200 different types, or from a nasal allergy. Influenza, commonly known as flu, is caused by a dangerous and mostly fatal viral illness of which swine and bird flu are some examples.

A common cold usually ends up in cough and may have associated headaches, fever or even muscle pains unlike an allergy which usually is associated with a headache, body itching with a cough that frequently causes difficulty in breathing, chest tightness and wheezing.

Viruses are difficult to treat but the body usually develops resistance to them so that once a particular virus attacks, the body develops substances or even cells which recognise that particular virus and fights it off once it returns. A child in Baby Class may keep getting various common cold viruses from different children but with time will resist those that have affected it so that over time, the attacks eventually scale down and are almost all gone by the time the child is in primary school.

Allergies occur due to an interaction of environmental and genetic factors and may show preference to families. However, these allergies may also be outgrown, so that by the time the child is in primary school, they are less likely to suffer from them.

Any child with a runny or stuffy nose needs to be kept warm, be given warm fluids and be kept away from antibiotics, which apart from not killing common cold viruses, may actually cause their own allergic reactions. If the symptoms persist, you need to visit your doctor.